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For Restored Works (United States)

This is a copyright form for restored works. The form provided here is simply a sample of what the actual Form GATT/GRP looks like.

FORM GATT/GRP
For Restored Works
UNITED STATES COPYRIGHT OFFICE

TX ____ PA ____ VA ____ SR ____ SRU

Registration Number ___________________________

Month ___________________________

Day ___________________________

Year ___________________________

DO NOT WRITE ABOVE THIS LINE. IF YOU NEED MORE SPACE, USE A SEPARATE CONTINUATION SHEET.

1a TITLES

1. Title ___________________________

English translation ___________________________

2. Title ___________________________

English translation ___________________________

3. Title ___________________________

English translation ___________________________

4. Title ___________________________

English translation ___________________________

1b DESCRIPTION OF THE WORKS: (Check one or more)

____ literary work

____ musical work, including any accompanying words

____ dramatic work, including any accompanying music

____ pantomime or choreographic work

____ pictorial, graphic, or sculptural work

____ motion picture or other audio/visual work

____ architectural work

____ sound recording, created in ___________________________

2 AUTHOR(S):

a Name ___________________________

Citizenship (when work was created): ___________________________

Domicile (when work was created): ___________________________

Date of death: ___________________________

b Name: ___________________________

Citizenship (when work was created): ___________________________

Domicile (when work was created): ___________________________

Date of death: ___________________________

3 YEAR AND NATION OF PUBLICATION:
(If the works were published, give the year and nation in which they were first published.)

Year: ___________________________

Nation: ___________________________

DO NOT WRITE HERE. OFFICE USE ONLY.

APPLICATION RECEIVED ___________________________

DEPOSIT RECEIVED ___________________________

FUNDS RECEIVED _____________________

4a OWNER(S) OF U.S. COPYRIGHT:

Name: ___________________________

Address: ___________________________

___________________________

4b Means by which copyright ownership was transferred (if owner is not the author):

___________________________

5 LIMITATION OF COPYRIGHT: If, for any work in the group the registration does not extend to the entire work, give the title and describe the material that is covered by the registration (see instructions):

___________________________

6 PREVIOUS REGISTRATION: If any of the works were ever registered in the U.S. Copyright Office, give the title, registration number, and year if known:

___________________________

7 DEPOSIT ACCOUNT If the registration fee is to be charged to a deposit account established in the Copyright Office, give the name and number of that account. Do not give credit card information on this form.

Name ___________________________

Account Number ___________________________

CORRESPONDENCE Give the name and address to which correspondence about this application should be sent.

____ Agent of ___________________________ (Name of author or owner of U.S. copyright) of the works identified in this application and that the statements made by me in this application are correct to the best of my knowledge.

Typed or printed name: ___________________________

Data: ___________________________

Handwritten signature ___________________________

Address

Name ___________________________

Number/Street/Apt ___________________________

City/State/ZIP/Nation ___________________________

9 YOU MUST:
• Complete all necessary spaces

SEND ALL ELEMENTS IN THE SAME PACKAGE:
1. Application form
2. Nonrefundable filing fee in check or money order payable to Register of Copyrights